医疗卫生装备2024，Vol.45Issue(8)：57-62,6.DOI:10.19745/j.1003-8868.2024154
CBCT和EXT图像引导系统在高级别脑胶质瘤放疗中的应用分析
Application of combined cone-beam CT and ExacTrac X-ray image-guided system in high-grade glioma radiotherapy
摘要
Abstract
Objective To explore the optimal image-guided verification mode by using combined cone-beam CT(CBCT)and ExacTrac X-ray(ETX)image-guided system for the position verification during the first and remaining fractionated radiotherapy of high-grade glioma patients.Methods Twenty high-grade glioma patients undergoing intensity-modulated radiotherapy at some hospital from January 2018 to June 2020 were analyzed retrospectively.CBCT image-guided system was used for the patients treated for the first time to determine the corresponding position of the treatment center on the body surface and to reset and mark the treatment center,then on-line auto registration of the CBCT images with CT positioning images was carried out,and the residual setup errors were verified with ETX image-guided system;position verification of the setup errors was performed with ETX image-guided sysem during the remaining fractionated treatment.The setup errors and their interval distributionswere calculated for the patients in six directions including left-right direction(Lat),head-foot direction(Lng),anterior-posterior direction(Vrt),rotation around left-right(Pitch),rotation around head-foot(Roll)and rotation around anterior-posterior(Yaw).SPSS 22.0 statistical software was used for data analysis.Results There were 75％patients treated for the first time and 78.62％ones undergoing the remaining fractionated radiotherapy only needed one time of setup error corre-ction.Combined CBCT and ETX image-guided resetting during the first radiotherapy met clinical requirements;during the remaining fractionated radiotherapy there were significant differences between the setup errors in the six directions before and after calibration(P＜0.05).The interval distribution of setup errors showed the error values in the six directions were all restricted within 0 to 1 mm and within 0° to l °during the first and remaining fractionated radiotherapy.Conclusion Involve-ment of combined CBCT and ETX image-guided system in the first and remaining fractionated radiotherapy of high-grade glioma patients after operation contributes to determining and resetting the treatment center rapidly and accurately,decreasing setup errors and enhancing the accuracy and repeatability of radiotherapy.[Chinese Medical Equipment Journal,2024,45(8):57-62].关键词
ETX图像引导系统/CBCT图像引导系统/调强放疗/摆位误差/脑胶质瘤Key words
ExacTrac X-ray image-guided system/cone-beam CT image-guided system/intensity-modulated radiotherapy/setup error/glioma分类
医药卫生引用本文复制引用
周军,李寒旭,黄志兵,万久庆,李东春,钟良志..CBCT和EXT图像引导系统在高级别脑胶质瘤放疗中的应用分析[J].医疗卫生装备,2024,45(8):57-62,6.基金项目
重庆市科卫联合医学科研青年项目(2018QNXM034) （2018QNXM034）
